Division of Clinical Pharmacology, Department of Medicine, Autonomic Dysfunction Center, Vanderbilt University School of Medicine, AA3228 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232-2195, USA.
Clin Auton Res. 2013 Jun;23(3):117-22. doi: 10.1007/s10286-013-0190-1. Epub 2013 Mar 7.
Vasovagal syncope (VVS) is a chronic debilitating condition seen mostly in young women of reproductive age. There are anecdotal reports of increased syncope and presyncope around menstruation. This case-control study assessed the effects of the menstrual cycle on lightheadedness episodes and compared the gynecological and pregnancy history of VVS patients to healthy subjects.
A custom-designed gynecological and menstrual cycle questionnaire was previously developed for patients with orthostatic intolerance. This questionnaire was administered to female patients with VVS (n = 128) as a part of the multicenter Second Prevention of Syncope Trial, and to gender-matched healthy subjects (n = 92).
VVS patients and healthy subjects reported significant variability in self-reported lightheadedness throughout the menstrual cycle. Both cohorts experienced greatest lightheadedness during menses (53 ± 2 vs. 56 ± 4), which decreased during the follicular phase (44 ± 2 vs. 41 ± 4). VVS patients reported less severity in premenstrual symptoms (Fisher's method P = 2.7E-06) compared to healthy controls. There is no difference in the incidence of gynecological abnormalities (Fisher's exact P = 0.193) and pregnancy complications (P = 1.0) between the two cohorts. VVS patients have similar pregnancy rates compared to healthy subjects (P = 0.674).
The severity of lightheadedness varies during the menstrual cycle and is similar in both VVS patients and healthy controls. VVS patients have no greater risk of gynecological abnormalities and pregnancy complications than healthy subjects.
血管迷走性晕厥（VVS）是一种常见于年轻育龄期女性的慢性衰弱性疾病。有一些关于月经周期周围晕厥和先兆晕厥增加的传闻报告。本病例对照研究评估了月经周期对头晕发作的影响，并比较了 VVS 患者和健康受试者的妇科和妊娠史。
先前为直立不耐受患者设计了一种妇科和月经周期专用问卷。该问卷作为多中心第二次晕厥预防试验的一部分，被用于女性 VVS 患者（n=128）和性别匹配的健康受试者（n=92）。
VVS 患者和健康受试者报告称，在整个月经周期中，自我报告的头晕症状存在显著的变异性。两个队列在月经期间都经历了最大的头晕（53±2 对 56±4），在卵泡期期间减少（44±2 对 41±4）。与健康对照组相比，VVS 患者报告的经前期症状严重程度较轻（Fisher 方法 P=2.7E-06）。两个队列之间在妇科异常（Fisher 确切概率 P=0.193）和妊娠并发症（P=1.0）的发生率方面没有差异。VVS 患者的妊娠率与健康受试者相似（P=0.674）。
头晕的严重程度在月经周期中有所变化，在 VVS 患者和健康对照组中相似。VVS 患者发生妇科异常和妊娠并发症的风险并不高于健康受试者。
